Gum Disease (Gingivitis)

  • Medical Author:
    Steven B. Horne, DDS

    Dr. Steve Horne began his career at Brigham Young University obtaining his BA in English. He earned his Doctorate of Dental Surgery in 2007 from the University of Southern California where his pursuit for academic excellence landed him on the Dean's List. He was recognized for his superior clinical skills and invited to help teach other dental students in courses on restorative dentistry, prosthodontics, and tooth anatomy. During dental school, he provided dental care for underserved populations of Los Angeles and Orange County, Mexico, and Costa Rica with AYUDA. Following dental school, Dr. Horne entered active duty with the U.S. Army and practiced dentistry at Fort Knox, Kentucky, for four years. During this time, he was deployed to Baghdad, Iraq, and received multiple Army Achievement Medals, the Army Commendation Medal, and served as Company Commander. Dr. Horne currently practices full time at Torrey Pines Dental Arts in La Jolla, California, as a general dentist. Dr. Horne is a member of the American Dental Association, the California Dental Association, and the Academy of General Dentistry. Dr. Horne is married to his wife, Christy, and they have a chocolate Labrador named Roscoe.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What is the treatment for gum disease?

The treatment goals for gingivitis are to identify and eliminate the factors that are making the person more susceptible to gum disease. Most factors can be eliminated by establishing more consistent and thorough oral hygiene habits and professional dental cleanings. If there are certain risk factors such as smoking or uncontrolled diabetes that are contributing to the gum disease, they need to be addressed or eliminated to have success in reversing gingivitis. After the plaque and tartar are removed by a dentist or hygienist, the patient can usually cure gum disease by brushing and flossing after every meal and using a daily mouth rinse. Under the supervision of a dentist, a patient can use 10% carbamide peroxide in a custom made tray that fits over the teeth with positive effects on plaque control and gingival health. This is especially helpful in patients where conventional oral hygiene practices like brushing and flossing are impaired due to age or special needs.

In cases where gingivitis has led to periodontal disease and there are deep pockets that are difficult to clean, the patient may require deep scaling and root planing to clean teeth that are surrounded by deep pockets. They may need surgical treatment to gain access to all the tooth surfaces for a thorough cleaning. This surgical procedure is called flap surgery and can be combined with a pocket-reduction surgery to make the areas around the teeth easier for the patient to clean with brushing and flossing. This procedure consists of numbing the gums and then lifting them back to clean the teeth and sometimes reshape the bone. The gums are then repositioned around the teeth so there aren't the deep pockets that existed before treatment.

Soft-tissue grafts are used to cover up root surfaces that have been exposed by receding gums. This can help eliminate sensitive teeth and protect the root surfaces that are softer and more difficult to clean.

Laser therapy is another treatment to help increase gum health. The gum pocket is treated with a soft tissue laser to eliminate the harmful bacteria deep in the periodontal pockets, remove unhealthy tissue and help stimulate healing.

What types of specialists treat gum disease?

Periodontists are dentists who have completed additional training after dental school focused entirely on the evaluation, diagnosis, and treatment of disease of the gum and bone surrounding the teeth. In advanced cases of gingivitis or periodontal disease, a general dentist may recommend a gross debridement of superficial plaque and tartar and will then refer the affected patient to a periodontist for evaluation. Periodontists may recommend a variety of nonsurgical or surgical procedures to help stabilize the gum condition. Periodontists are also very skilled at performing treatments of other conditions of the gums and bone including gum and bone grafts, functional and esthetic gingivectomy, gingivoplasty, implants, and crown lengthening.

What types of medication are used to treat gum disease?

Antibiotic therapy can be combined in various ways to help treat gingivitis, periodontal disease, and especially ANUG. Chlorhexidine (Peridex) is an antibiotic mouthwash that can be used under direction of a dentist to help reduce the bacteria that cause gum disease. Pellets or gels like PerioChip that contain the antibiotic chlorhexidine or doxycycline can be placed in deep gum pockets after deep scaling and root planing to kill stubborn bacteria and reduce the size of periodontal pockets. These modes of delivering antibiotic therapy are very effective because the antibiotic is released slowly over the course of about seven days. Additional treatment such as xylocaine and NSAIDs may be needed for pain control in chronic gingivitis and ANUG.

Medically Reviewed by a Doctor on 4/6/2016

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